Effectiveness of ultrasonography-guided pericapsular nerve group block in patients with adhesive capsulitis resistant to conservative treatment: A prospective observational study

This prospective observational study aimed to evaluate the effectiveness of ultrasonography-guided pericapsular nerve group block (PENG-b) in shoulder pain, function, and kinesiophobia in patients with adhesive capsulitis (AC) resistant to conservative treatment. Sixty-one patients diagnosed with resistant AC were included in this study. Thirty-one patients received PENG-b followed by mobilization (Group 1), while 30 received only mobilization therapy (Group 2). All patients underwent mobilization therapy thrice a week for 6 weeks, targeting ≥80% shoulder range of motion (ROM). Pain was assessed using the Visual Analog Scale, function using the Disabilities of the Arm, Shoulder, and Hand questionnaire and Modified Constant-Murley Score, ROM via goniometry, and kinesiophobia using the Tampa Scale. Group 1 reached the targeted ROM in 10.3 ± 1.6 sessions (range 6-12), whereas all patients in Group 2 required 18 sessions (P < .001). Both groups showed significant posttreatment improvements in Visual Analog Scale, ROM, Modified Constant-Murley Score, Disabilities of the Arm, Shoulder and Hand, and kinesiophobia scores (P < .001). However, Group 1 demonstrated significantly superior outcomes across all measures compared to Group 2 (P < .001). Pain relief was also observed within 24 hours after injection in Group 1. PENG-b provided rapid pain relief and enhanced the effectiveness of subsequent mobilization therapy, resulting in better functional recovery and reduced kinesiophobia within a shorter timeframe. These findings suggest that PENG-b is a safe and effective pre-rehabilitation intervention for patients with AC who are unresponsive to conventional treatments.